Denied medicaid.

Original igloo here: First of all MediCARE is paying that hospice group about $4500 a month to do in home hospice care for your mom. Not an insignificant sum. You as her POA can ask to have the # of hours currently given to be reassessed to have an increase. You should also look into whether her secondary health insurance has any benefits for coverage for hospice as some policies actually do a small copay as a benefit. Her $2100 a month income should be able to be paying the cost for caregivers needed the times in which hospice is not there and you are working. In home hospice is a great benefit but does require someone in the family network to be there all the other nonhospice time as a caregiver / oversight; community Medicaid’s PACE program does the same thing, and for some folks this flat just cannot work.

FWIW hospice as a benefit provided 100% by Medicare is only done if you have paid into FICA and worked in the US with enough quarters to be fully eligible for Part A coverage. And guess what, that means anyone illegally in the US will not ever get this as a benefit.

Regarding Medicaid, huge # of programs. Very much is as mrtrbill posted!

Has your mom actually filed an application for LTC Medicaid (program that pays for custodial care in a NH) OR is this just a rant? Like did she actually enter a facility, filed the application & is also fully “at need medically” for skilled nursing care so meets the requirements for aspect of LTC Medicaid as well and now has gotten an ineligibility determination? If so, exactly why is your mom ineligible for it?
OR….
is this just something that you are guessing that is going to happen once she actually does file an application based on what the LTC Medicaid program is required to review as a part of the 5 yr “look back” on your mom’s finances??? I’m guessing it’s this….
At $2100 a month income, mom is ok for the income limit for LTC Medicaid as most states have it at $2742. So the ineligibility has to be due to something else….. and the main reason for ineligibility is that the parent has “gifted” $ or assets to their kids within the 5 year look back period. They wrote checks or withdrew large sums of $ or flat outright transferred assets into kids names. Penalty’s penalties & more penalties on stuff they did with their $$$ and it’s all easy peasy to see in their bank statements and joint bank accounts. I’m guessing that based on how you described your own dire financial circumstances, job loss, RV etc that mom has lent you $ or paid your bills or maybe even consigned for stuff for you. If this did happen, it will surface in the lookback and will pose transfer penalties for your mom’s eligibility for LTC Medicaid. So yes, she will be denied Medicaid. & she will have a transfer penalty placed on her application as well.

If this is kinda what you anticipate will happen, dealing with transfer penalties can be done by your mom but imho & not an attorney opinion, she - not you - will have to get with an elder law attorney on this to discuss what her options could possible be. & best done before ever filing the LTC application.

“freebies to millions of illegals on a silver platter” that’s a fallacy.

Did you apply her for community Medicaid or LTC (nursing home) Medicaid? There is a big difference between the two. Your mom needs nursing home Medicaid, and she will qualify if she medically needs it. I was in a similar situation with my father. His income was about the same, and he or I couldn’t afford in home caregivers. I sent him to the hospital, the hospital sent him to a nursing home, and LTC Medicaid paid for it. I had to work like you do, so I couldn’t be home to look after him. If the social workers know this, and mom is in danger being alone, then they must take steps to ensure her safety, which means full time care in a facility. So you need to get a social worker to intervene, either from the hospital or from the state.

Aparadox, what helped me was Legal Aid. Maybe try contacting your local Senior Resource Center for that,
Elder Law attorneys are expensive. Would you be paying that out of your pocket?
I would call you local DSS, and try to get someone locally to help you address Medicaid. A lot of times calling the 1 800 numbers makes you and your Mother just another number.
This is just my opinion.
Also, a lot of times Senior Center have programs to help with so many things that involve taking care of the elderly/Senior person.
You're not alone. A lot of seniors didn't plan on old age, but it's a mute point when you're trying help them right now.
People who are proud and never had to ask for help and worked all of their lives are now relying on us(their retirement plan) are having to ask for them. Oh, the irony.
Take care. Like in the movies, put you oxygen mask on first.
And to clarify we used Legal Aid to draw up Mom's will, POA and advanced directives. Not sure if there are Elder Law attorneys that do that for free, you can ask.
Local ombudsman for your county are also a helpful resource.

If you're paying for her PT caregivers, where does her $2100 in SS go every month...? Does it just cover her rent and other expenses? Does she have no other assets or savings whatsoever? Doesn't own a house that can be sold?

A Miller Trust is something to discuss with an estate or Medicaid Planner for her home state. Medicaid in most states only covers LTC, which is medically assessed as necessary by a physician, plus needing to qualify financially. Most states have a 5-year look-back period on the financial portion of the application.

See an elder law attorney. He/she will help you work around the laws specific to your state in whatever ways you are able, say a Miller Trust, or whatever. You can't DIY on this stuff. You need expert advice.

I hope igloo is around on this specific holiday time, as she has good ideas how you can get advice, but it needs to be expert advice. Hopefully someone on this Forum is from your state (what State are you in) and can begin telling you where to go. Also talk to medicaid. Go to medicaid.org and look up your specific state's rules.

There ARE ways around this, trust me. They will NOT, however, get you ALF or MC. They will get you the same of nursing home that most people (even illegals) end up in. There's no way around not having saved up enough for age, or not having assets from sale of home, and etc to get you a good place in ALF. No way around it for anyone.

I wish you the best of luck, and again, get EXPERT advice for this complicated question. Make an appt with an elder law attorney and have at hand income, assets (all assets) and etc. Good luck. Hope you will update us as to what you learn.

Aparadox, welcome!

I need to ask a bunch question so we can get you the help you need.

1. Your mom has to be medically AND financially qualified for Nursing Home Medicaid. Was she denied ONLY on a financial basis?

2. Have you consulted a Medicaid planner or Elder Law attorney? In most states, there are provisions for elders who are just a bit over the limit. Have you investigated whether mom's state is one that allows pooled income trusts or if there is a spend down provision? With the expense of NH Care, mom's income will almost certainly be under the limit.

Please come back to we can provide good guidance. Don't lose heart.

https://www.medicaidplanningassistance.org/

You mention in your profile that mom is living in independent living.
Is that Independent Living in a facility or in her home or condo?
If in a facility can she be moved to AL or even Skilled Nursing? She would have more staff to care for her and you may not have to have hired caregivers. If she is living in her home or condo you sell the home or condo and the money from the sale will pay for the care that is needed.
Side note YOU should not be paying for caregivers that comes from moms accounts.